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#7565 of 11K

E0435

HCPCS Procedure Code

HCPCS code E0435 is the #7,565 most-billed Medicaid procedure code, with $15K in payments across 539 claims from 2018–2024. The national median cost per claim is $14.28. Costs vary widely — the 90th percentile is $60.48 per claim, 4.2× the median.

Total Paid

$15K

0.00% of all spending

Total Claims

539

Providers

3

Avg Cost/Claim

$27

National Cost Distribution

How much do providers bill per claim for E0435? Based on 3 providers billing this code nationally.

Median

$14.28

Average

$30.55

Std Dev

$36.20

Max

$72.03

Percentile Distribution (Cost per Claim)

p10
$7.12
p25
$9.80
Median
$14.28
p75
$43.16
p90
$60.48
p95
$66.25
p99
$70.87

50% of providers bill between $9.80 and $43.16 per claim for this code.

90% bill between $7.12 and $60.48.

Top 1% bill above $70.87.

About This Procedure

HCPCS code E0435 was billed by 3 providers across 539 claims, totaling $15K in Medicaid payments from 2018–2024. This code was used for 439 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$14.28

Providers Billing

3

National Spending

$15K

Avg/Median Ratio

2.14×

Highly skewed — outlier-driven

Provider Coverage

We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.